Story: Child and youth health

Page 6. Primary health initiatives

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Plunket

The Royal New Zealand Plunket Society provides free health and welfare services for children aged five and under. Plunket nurses take over from midwives and other maternity carers when a baby is between four to six weeks old.

Plunket was founded by Dr Frederic Truby King in 1907. In this period, improving maternal and infant health was seen as critical to producing fit and productive citizens. While Plunket’s self-proclaimed success in reducing infant mortality rates single-handed was overstated, providing mothers with breast and formula feeding and hygiene advice probably contributed to this reduction.

Women’s movement

Though Plunket was founded by a man, the work of the organisation was sustained by women – both professional nurses and women volunteers. It became the most successful and well-known voluntary organisation in the country. By 1959 there were around 600 Plunket branches and 250 mothers’ clubs, all staffed and run by women. The School Medical Service was also dominated by women.

Health and education

The School Medical Service was established in 1912 and continued the work of Plunket into the school years. Initially run by the Department of Education, the service was overseen by the school hygiene division of the Department of Health from 1921. Public health nurses employed by the department later took over this work.

Children were medically examined by doctors three times during their time at school. Those with health problems were seen more regularly. Nurses visited children in their homes. They helped treat minor complaints and sent those with more serious problems to doctors. Teachers were also supposed to instruct children on topics like healthy eating and personal hygiene.

Nutrition became a major focus. Most school children were given a half-pint (0.2 litres) of milk each school day between 1937 and 1967. Free apples were also distributed until 1948.

Spoil sport

In the 1940s New Zealand ice cream manufacturers tried to get ice cream into schools along the same lines as the free milk scheme. However, Department of Health nutrition officer Dr Muriel Bell opposed this proposal, and school children had to be satisfied with straight milk. The New Zealand Ice Cream Manufacturers’ Association said: ‘If the Health Department cannot at present give approval for daily ice cream for school children, a time seems not far distant when we shall at least see better-advised communities abroad giving children what they like, and what, in the case of good ice cream, is nourishing.’1

In the early 21st century most schools had an on-site nurse, while children received medical examinations and care from their family doctor. The health issues most promoted in schools were physical activity, sun protection and remaining smoke free. Children in schools in areas defined as having high health needs were given free fruit. Some children in low-deprived areas were also provided with free breakfasts funded by private businesses or charities.

Health camps

Children’s health camps are places where children aged 5–12 with health, family-related, behavioural and learning problems are cared for temporarily. Individual programmes designed to improve health and well-being are drawn up for each child. In the 2010s there were seven camps (by then called 'children's villages'), run by Stand Children's Services, Te Maia Whanau, which received government funding for this service.

The first health camp opened at Turakina (near Whanganui) in 1919. For the first few decades malnourished and pre-tubercular children were the main focus. After the Second World War social and emotional problems were increasingly emphasised. From the late 20th century child-abuse victims were also cared for and there was a renewed focus on malnutrition.

General practice care

From 2015 most general practitioners (GPs) saw children under the age of 13 for free. Prescriptions for this group were also free. Fees for older children and young people varied depending on the practice, and prescriptions attached the standard $5 per item charge. From December 2018 free visits were also available to 13-year-olds.

Youth health care

Young people (15–24 years) were traditionally not considered to have particular health issues and needs. This was because most had good health and low levels of chronic illness, and used health services less than other age groups. On the other hand, death rates increase significantly from around 14, mainly because of increases in unintentional injury and suicide.

In the late 20th century more notice was taken by health researchers of issues which affect youth. The first national youth health and well-being survey was undertaken in 2001 and the Ministry of Health produced a Youth Health Plan of Action in 2002 that recognised that there was a need for young people to participate in the development of health policy and have input into service development.

Primary health services for young people took a ‘one-stop shop’ approach from the 1990s. Services available from one provider usually encompassed physical, mental, emotional and social health needs. An example of this type of primary health service for young adults is the 298 Youth Health Centre in Christchurch, which provides free sexual, mental and GP services to young people. Evolve youth health and social support service provides similar services in Wellington. Both facilities are part of a network of Youth One Stop Shops around New Zealand that respond to the health needs of young people.

Another youth health initiative is Bounce, which is facilitated by the New Zealand Red Cross. It provides online information about health and well-being for young people. It developed following the 2010–11 Canterbury earthquakes and is a peer-led project run by young people for young people.

Kidz First Centre for Youth Health in Auckland provides specialised support and care for young people with health issues and youth development concerns, including transgender care. The focus is on young people but also support for their whānau.

Children’s hospitals

The first hospital wards for children appeared in the 1880s. The Princess Mary Hospital for Children opened on the grounds of Auckland Hospital in 1918. Its services were absorbed into Starship Hospital, the major stand-alone children’s hospital in New Zealand, which opened in 1991.

Kidz First Children's Hospital was established in 2000 as a purpose-built facility to deliver family centered health care in South Auckland – a culturally diverse community. Like Starship Hospital it offers inpatient paediatric surgical and medical care, and includes a Child Protection Service. A Wellington Regional Children's Hospital will open in 2021.

Most hospitals in New Zealand had children’s wards that provided a child-friendly environment for patients.

Footnotes:
  1. Quoted in Derek A. Dow, Safeguarding the public health: a history of the New Zealand Department of Health. Wellington: Victoria University Press, in association with the Ministry of Health and with the assistance of the Historical Branch, Dept of Internal Affairs, 1995, p. 143. Back
How to cite this page:

Kerryn Pollock, 'Child and youth health - Primary health initiatives', Te Ara - the Encyclopedia of New Zealand, http://www.TeAra.govt.nz/en/child-and-youth-health/page-6 (accessed 12 December 2018)

Story by Kerryn Pollock, published 5 May 2011, reviewed & revised 29 Nov 2018